50 Square Blocks
December, 21, 2015- in category Leadership
‘Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’
Mathew 25:44 NIV
In 17 years of working in the heart of Skid Row at the Los Angeles Christian Health Centers (LACHC) not a day passes when I don’t see someone who is hungry or seemingly a stranger, or needing clothing, or sick. At LACHC, it’s our mission to provide health care for people who are in these conditions. Still, the magnitude of the suffering we witness is so great that it’s hard to accept. Sixty-seven percent of the patients we care for at Joshua House are homeless. More than half screen positively for depression, anxiety, substance abuse or other mental health disorders. Thirty percent are elderly. And frankly, these are facts and conditions that I cannot accept or overlook. This blog aims to raise the visibility of these issues; shed light on our perspective as a Christian organization committed to sharing God’s love through this work and; influence and contribute to the conversation and policy agendas focused on homelessness.
Years ago, I signed on as a homeless healthcare provider and I knew I wanted to be a voice for people who largely don’t have a voice. As the first staff physician for the clinic, I was a voice on the streets delivering healthcare and speaking privately with patients. As Chief Medical Officer of LACHC I was a voice speaking up for quality of care and coverage. As President and CEO, I’d like to expand the reach of my voice through this blog. My hope is that what I have to say reaches a wider audience of people who are concerned and interested in our cause.
The timing seems right. The systemic ‘issue of homelessness’ is getting a lot of desperately needed attention in Los Angeles. I am grateful for every solution that rightfully connects supportive services to permanent housing, recovery programs and shelters. At LACHC we strive to connect services like medical, dental, mental health care and case management to every access point. That’s why we are in the homeless shelters, permanent supportive housing and on the streets.—I believe there is no wrong door to end the cycle of homelessness. I also believe that there is still room for improvement. More people need to have access to options and more doors through which to improve their lives.
Los Angeles Homeless Services Authority (LAHSA) Homeless Count stats for 2016 confirm the need for more services and solutions. In LA County the number of people experiencing homelessness is up 5.7% from the last count in 2015 (LAHSA, 2016). And while people experiencing homeless are so much more than what the numbers tell, the numbers are important to outline the scope of the challenges our cause faces:
- 26% of all people who are homeless are struggling with significant mental illness.
- 25% are dealing with chronic substance use issues.
- 31 to 46% suffer from one or more chronic health conditions, such as diabetes, hypertension, asthma.
- 12% are veterans, the majority of whom suffer from mental illness and addiction.
- 22% have experienced domestic violence.
- 21% have lived in foster care, group homes, or other institutional settings at some point in life.
- 21% are physically disabled.
- 92 percent of mothers who are homeless have experienced severe physical and/or sexual abuse.
I’m always struck by these types of statistics, but not surprised by them. We see them come to life every day in the stories of the patients we care for. And lately our patients are more likely than ever to have multiple illnesses and complex, chronic conditions.
Regardless of the mixture of factors that lead to an individual becoming homeless, we know that once this happens, a downward spiral follows quickly. Mental and physical illness are exacerbated. Combine this with unsanitary living conditions, exposure to communicable disease, poor nutrition and high rates of trauma and violence and we can see why every year many people who are homeless die on the streets.
At LACHC they call me Dr. Lisa- though Lisa is just fine with me. In addition, I am a wife, a mom of two and a Christ-follower, a music lover and a person filled with gratitude for the opportunity I’ve been given to guide this incredible organization committed to seeing things change. I believe in evidence based practices, but I don’t think that always tells the whole story. I’m someone who wakes up early in the morning with my head full of questions. Are we doing all that we can to care for people who live on the margins? How can we make an even greater impact? Are we keeping the compassion we started this with, or have we become numb? When looking into the eyes of our patients, do we still see people who are homeless, or do we just see homeless patients? I carry this with me along with a commitment to fulfill LACHC’s mission to share God’s love by providing quality comprehensive care to people affected by poverty and homelessness.
Specifically, I believe that health care is an essential component to stabilizing someone’s life – it is a vital part of sustaining the end to homelessness and must be part of the way policies are created and solutions are framed. It is also vital that people who have experienced chronic homelessness receive specialized health care that is sensitive to the health needs that the trauma of people who have lived or still live on the street.
I will share Los Angeles Christian Health Center’s perspective on what it means to do Christ’s work. People often ask me, how does being a Christ-like /Christ-centered organization effect the health care outcomes of patients? Does it? I assure you it does, and I will explore this and share the difference it can make, whether the person receiving the care adheres to the Christian faith, a different faith, or no faith at all.
I hope to engage people in discussions about leadership in an age when it seems uncertainty has become the norm and chaos and disruption are sought after consequences.
I intend to raise nagging questions as we navigate the industry shift from payment-by-encounter to a capitated system with a greater emphasis on value and outcomes.
Thank you for joining me here. I plan to write a blog every few weeks, and I hope you will stay engaged and keep reading.
I’d like to leave you with one last thought. For years I have been so glad and so proud to be a “health care for the homeless” provider. I’ve talked about “the homeless” a million times. That term is etched into my vocabulary. But I’m realizing now how much our words matter. And that while creating labels for groups of people may be convenient and concise, it also dehumanizes… and it doesn’t help me love people more. So I’m trying to take the simple step of stopping this habit. Will you join me in giving up the label “the homeless” and start referring to “PEOPLE who are homeless”?
LAHSA. (2016, May 10). 2016 Homeless Count Results Los Angeles County and LA Continuum of Care. Retrieved from Los Angeles Homeless Services Authority: https://documents.lahsa.org/Planning/homelesscount/2016/factsheet/2016-HC-Results.pdf
- Health Reform
- Homelessness and Health Care